Nephrectomy

Jinu Janet Varghese

Group 4

TSMU

Definition A nephrectomy is a surgical procedure for the

removal of a kidney or section of a kidney.

History

Laparoscopic Nephrectomy was first performed in 1990 by Clayman, Kavoussi et al, where

they removed the Right kidney from a patient diagnosed with Renal Oncocytoma

The first successful nephrectomy was performed by the German surgeon Gustav Simon on

August 2, 1869 in Heidelberg. Simon practiced the operation beforehand in animal

experiments. He proved that one healthy kidney can be sufficient for urine excretion in

humans.

Laproscopic approach to kidney

Transperitoneal Retroperitoneal

Procedure The surgery is

performed with the patient under general anesthesia. The surgeon makes an incision in the side of the abdomen to reach the kidney.

The ureter and blood vessels are disconnected, and the kidney is then removed. The surgery can be done as open surgery, with one incision, or as a laparoscopic procedure, with three or four small cuts in the abdominal and flank area.

Recently, this procedure is performed through a single incision in the patient's belly-button. This advanced technique is called as single port laparoscopy.

Purpose

Nephrectomy, or kidney removal, is performed on patients with severe kidney damage from disease, injury, or congenital conditions. These include cancer of the kidney (renal cell carcinoma); polycystic kidney disease (a disease in which cysts, or sac-like structures, displace healthy kidney tissue); and serious kidney infections. It is also used to remove a healthy kidney from a donor for the purposes of kidney transplantation

Risks

Possible complications of a nephrectomy procedure include infection, bleeding (hemorrhage), and post-operative pneumonia. There is also the risk of kidney failure in a patient with impaired function or disease in the remaining kidney.

Aftercare

Nephrectomy patients may experience considerable discomfort in the area of the incision. Patients may

also experience numbness, caused by severed nerves, near or on the incision. Pain relievers are

administered following the surgical procedure and during the recovery period on an as-needed basis.

Although deep breathing and coughing may be painful due to the proximity of the incision to the diaphragm, breathing exercises are encouraged to prevent pneumonia. Patients should not drive an

automobile for a minimum of two weeks.